Alimentary Gastro-intestinal system

(DIGESTIVE SYSTEM)

Appetite: normal, lowered, loss of appetite (anorexia), voracious, perverted (predilection to sour, salty, to unusual products), disgust for meat, fat food etc.

Saturability: normal, fast, filling of completeness in a stomach after use of a small quantity of food, liquid.

Taste in a mouth: usual, dullness, perverted (sour, bitter, metallic, sweetish), feeling of burning (pain) in language.

Thirst: the quantity liquids that takes in a day, drinks at night, in the morning on an empty stomach.

Chewing (mastication): well chewed food, quickly, inadequately chewed food (absence of a teeth, pains etc.).

Salivation (sialism): usual, excessive salivation (drooling), oligosialia, dryness in a mouth, property of saliva (character (liquid, thick), viscosity, etc.).

Swallowing and passage food through gullet: free, painful, difficult (dysphagia), what food stops (solid, liquid), at what level (in middle one-third of gullet, in bottom one-third of gullet), occasionally, systematically, connection with excitement, to take some water.

Abdominal pain: main site (epigastrium, right or left hypochondriums, iliac areas, flanks, umbilical, periumbilical, suprapubic areas, across the epigastrium). Character (aching, constricting, cutting, cause to burst, spasmodic, belting, gnawing, dull), constant, paroxysmal (attack-like). Severity (mild, moderate, severe, vere severe). Duration (minutes, hours, days). Radiation (in precardiac area, hypochondrium, under scapula (shoulder blade), in a back, the right shoulder, inguinal area, sacrum etc.). Connection with food intake (at once or soon after meal, in 2-3 hours, night pains, in the morning on an empty stomach — "hungry" pains). Quality of the food (salty, sour, sweet, fat, meat, rough, cold, hot etc.), bowel emptying, position of a body (standing, laying, on one side). Frequency and periodicity: seasonal prevalence (amplification in the spring, in the autumn, decrease or disappearance in the winter, in the summer). Relieving factors: intaking food, antacids, spasmolytic, artificial vomiting, applying heat, forced posture, etc.

Belching (eructation, regurgitation): gaseous (air), the eaten food, sour, bitter, with a smell of rotten eggs, putrefactive, with fecal smell; attacks loud eructation at excitement, in society.

Heartburn (pyrosis): connection with food intake, character, facilitating factors (intake soda, quantity, frequently).

Nausea: food intake dependence, duration, connection with pains, vomiting at end.

Vomiting: previous symptoms (nausea, amplification abdominal pain, headache as a migraine). Time of approach vomiting (in the morning on an empty stomach, during meal or right after it, in 2-3 hours — at height of pains, in 6-12 hours, at night), quantity of vomit mass (little, plentiful, projectile vomiting); their character (sour liquid, the slime, not changed food which has not visited a stomach — «esophageal vomiting», the ingested food of various digested, stagnant contents of stomach, food debris which ingested 12-24 hours ago). Smell (sour, putrefactive, «rotten eggs», fecal), impurity of bile, blood, (scarlet, dark, clots, as «coffee grounds»). If vomiting brings easing, if the patient initiates vomiting himself; recurrence vomiting (occasionally, in connection with errors in a diet, systematically, episodes of "intractable" vomiting).

Abdominal swelling: uniform, local (what area). Flatus: normal, heightened, difficult, connection with food character; rumbling in live.

Burning, itch in the anus; pain in defecating (in the beginning, at the end of the act); hemorrhoidal boluses, bleedings from them (frequently, blood loose quantity), rectal prolapse.

Stool (evacuation): not forced, regular, irregular, forced (after clysis, intake of laxative).

Constipation: how many days without stool, communication with character of a food, mode of life (hypodynamia).

Diarrhoea: how many times a day, urge to defecate (imperative, fecal incontinence, false urge to defecate), bowel emptying (fast, long, painful, painless), communication with character of a food.

Feces: quantity, consistency, appearance (shaped, sausage-shaped, ribbon, scybalous "sheep's", porridge-like, liquid, watery, rice-water stool, frothy stool etc.), color (brown, yellow, green, light-colored, “clayey”, "black", tarry stool), smell (usual, sour, putrefactive, fetid), accompanied (mucus, pus, the rests of not digested food, blood — scarlet, dark, on a surface of feces, evenly distributed), helminthes discharge.

Liver

Pains in the right hypochondrium: prolonged — aching, dull, constricting, cause to burst; paroxysmal (attack-like) — sharp, spasmodic, radiation (in the right shoulder, neck, scapula), accompanying symptoms (bitter eructation, vomiting, motor anxiety, high temperature, occulation urine, sclera’s icteritiousness, skin itch), aggravating factors — abnormality in a diet (plentiful meal, fried, fat), sharp movements (jolty driving, exercise stress etc.).

DIGESTIVE SYSTEM
Appetite	What does your appetite like?
Thirst	Are you thirsty? Do you feel thirst all the time?
Dysphagia	Do you have any difficulty on swallowing? Do you swallow easily? Is it difficult for you to swallow only solid food or fluid food as well? Has the difficulty on swallowing appeared suddenly or gradually'?
Pyrosis (heartburn)	Do you have pyrosis (heartburn)? How soon after meals do you feel burning? Is there anything that makes it better/worse?
Belching (eructation, regurgitation)	Do you have belching? What is the taste of your belching: sour, bitter? Do you belch with gas? Do you belch with food? Is there any putrid odour when you are belching?
Nausea	Do you have nausea? How many times a day do you nauseate?
Vomiting	Do you have vomiting? Do you fed sick at your stomach? How often do you vomit? How many times a day do you vomit? When do you vomit? Is the vomiting connected with meals? Is it related to eating? How much do you vomit? What colour is the vomit? Have you noticed any coffee - grounds, bile, blood in your vomit? Do you feel better after vomiting?
Pain	Do the pains trouble you? Where does it hurt you? In what region of the abdomen do you have a pain? Show with your finger the place where it hurts you. What's the pain like? What is the character of pain, mild, knife-like, severe, cutting, acute weak? What place does the pain radiate to? Is the pain permanent or periodic? Is it related to eating? Do the pains appear before meals (after meals, during meals)? Do the pains appear (disappear, subside, calm) at night (in the daytime)? How soon after meal do you feel pains? Do you feel pains just after the meal or 3-4 hours later? Does the pain depend on quantity and quality of food? What drugs relieve your pain? Do the pains decrease (subside, disappear) after taking medicine?
Stools	How often do you have your bowels opened? How many times a day do you have bowel movement? When did you have stool for the last time? How many days haven't you moved your bowels? Do you have constipation? Are you forced to use an enema? Do you take laxatives? Do you ever have diarrhea? What is the consistence of the faeces? Are they quite well formed? What about the colour? Have you ever seen any blood in your faeces? Is the blood in faeces of black or of pink colour? Were the faeces of brown (green, black, white-yellow) colour? Were they colourless? Is the fecal matter liquid as water, as rice-water? Is it foamy (mucous)? Have you noticed an unpleasant smell? Do you have to strain to pass your motions (tenesmus)? Do you get pain before, during or after passing your motions? Do you suffer from flatulence? Does the gas (flatus) pass on? Have you noticed any special food upsets your bowels? Did die worms (helminths) pass out?